Kathleen Grehan of Dot Sign Language highlights difficulties experienced by Deaf LGBT people visiting their GPs
Visiting the GP can be difficult, especially if you need to discuss a sensitive issue. Maybe you are suffering from anxiety or depression, perhaps you need to talk about a sexual health problem. It can take weeks to build up the courage to make the appointment, and once there a challenge to find the right words.
And if you’re LGBT, you often have to overcome a set of assumptions and – in effect – ‘come out’ repeatedly. What’s more, when your problem is of a more intimate nature, communication problems can make the situation much worse.
If you are Deaf, the challenge is raised to another level. Many GP practices still do not offer online bookings, and a telephone number is useless if you cannot hear. You arrive in person to find that nobody knows any British Sign Language (BSL), so you struggle through making the appointment by passing written notes back and forth.
At the appointment most Deaf BSL users want to be able to communicate in their own language. According to Sign Heath’s ‘Sick of It’ report 8 out of 10 deaf people want to use their own language but only 3 out of 10 are given the chance. Could you explain a complex medical condition in writing, including how you are feeling? Would you understand a GP’s written diagnosis?! It is worth pointing out that English and BSL are different languages with completely different grammar structures, so you would be communicating in your second (or sometimes third) language.
Is it appropriate for GP surgeries to ask the deaf patient to bring a family member or friend to translate for them? Would you feel comfortable with this, especially if the medical condition is connected to your sexuality? There have been many cases of children being asked to interpret for their Deaf parents. Should they be expected to take on this responsibility? No!
A qualified BSL interpreter (who will interpret from BSL to English and vice versa) should be used for any medical appointment if the Deaf person wants one. They are bound by their Code of Conduct to respect the confidential nature of any information they gain. Under the Equality Act 2010 the provision of an interpreter is a ‘reasonable adjustment’ private, public and voluntary sectors need to make to ensure Deaf BSL users needing their services are not at a ‘substantial disadvantage.’* This is law, but too frequently there is no interpreter available, or the receptionists do not know how to book one. There is now Video Relay Interpreting whereby an interpreter can be provided instantly through a computer or tablet. This has advantages but is impersonal and not always appropriate when discussing sensitive issues. Again, receptionist need to know how to book this.
It is no wonder that many LGBT Deaf people avoid going to the doctor.
Some GP practices are now booking their staff onto Deaf Awareness and basic BSL training. Attendees are often shocked at the statistics: It is much more common for doctors not to spot or diagnose health conditions in Deaf people. Deaf people suffer far higher incidences of obesity, mental health problems and behavioural disorders. Deaf people have twice the likelihood of high blood pressure and four times the likelihood of diabetes. Why is this? Because of the delays in seeing a Doctor, the communication breakdown in getting and understanding a diagnosis, and difficulties obtaining results. Many Deaf people do not understand why they are taking their medication. If you are Deaf, you don’t pick up snippets of health advice from the radio or overheard conversations; this means accessing information from the GP surgery is all the more important.
A half day training course will not enable practice staff to interpret appointments, but does offer insight into the challenges Deaf people face when entering the surgery setting and covers a basic introduction into signing i.e. greetings, finding out a name, date of birth etc. It is hoped that these courses will inspire and empower staff to be more inclusive.
What can you do?
- Insist that a qualified BSL interpreter is provided – these will have a yellow NRCPD badge.
- Register for the Emergency SMS service. This enables deaf, hard of hearing and speech-impaired people in the UK to send an SMS text message to the UK 999 service where it will be passed to the police, ambulance, fire rescue, or coastguard. The emergency services will respond by text. http://www.emergencysms.org.uk/
- Ask the GP Practice Manager to book Deaf Awareness training for staff.
- Visit http://www.dotsignlanguage.co.uk to find out more about training